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Fixing My White Spots

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I have always had white spots on my front teeth. I’m in my mid-twenties now and really want to have a smile that does not embarrass me. But, when I talked to my dentist about it, he assures me that my teeth are healthy and I should not mess with them. When I brought it up again at my next appointment he sighed and said, “If it’s bugging you that much, just whiten them.” I did, but that seemed to only serve to make the white spots brighter. What do I do now?

Kelly

Dear Kelly,

Before and After Dental Bonding repairing a chipped tooth

 

When I read your story, I rolled my eyes. Your dentist is likely a decent family dentist but he has no idea what he is doing when it comes to cosmetic dentistry. As you discovered, teeth whitening is not the correct solution for this. When you whiten your teeth, it does so evenly. This means that while your teeth will whiten, so will the spots.

There are two possible solutions for you with this depending on how severe or widespread your white spots are. If there is just a small amount of white spots on the tips of your teeth, then you could get away with dental bonding. The example shown above is of dental bonding used to repair a chipped tooth, but it can also be used to cover white spots.

If you are looking at a larger surface area, then you would be better served with porcelain veneers. This can cover the whole surface of your teeth. It can also do more than even out the color if you were interested in that. Veneers are the go-to for celebrity smile makeovers. They can change the shape, size, and color of your teeth. However, they are more costly than bonding.

One thing to be aware of is that you will not want your current dentist to do either of those procedures. Both are advanced cosmetic dentistry. As he doesn’t even understand basic teeth whitening principles, which is the absolutely easiest form of cosmetic dentistry, he is not qualified to do the advanced procedures. Otherwise, you will end up with a cosmetic dentistry horror story.

This blog is brought to you by Duluth, GA Cosmetic Dentist Dr. David Marion.

Can You Whiten Teeth to be as White as Eyeballs?

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I have a question that you will probably think is super weird, but I promise I have a good reason. Is there a way I could use teeth whitening to match my teeth to something like my eyeballs? I know, don’t laugh. But, I do need to know.

Harriet

Dear Harriet,

Teeth Whitening trays

I can’t promise I didn’t chuckle a little, but I love this question. In fact, it’s one of the most unique questions I’ve ever received. While it is possible to whiten your teeth to match the whites of your eyeballs, that would probably depend on how white they are. There are limits to what teeth whitening can do. One thing you you will find is that it is hard to get an exact match using that method because your teeth will continue to whiten for a week or two after you stop using the whitening gel.

If you are looking to get an exact match for something, then you would have better success with porcelain veneers. This can create a color match much more accurately. One thing to be aware of though is that while any dentist can do teeth whitening, porcelain veneers are an advanced procedure. It would require you to find a dentist who has invested in post-doctoral training in cosmetic dentistry. Dental school will not be enough.

The upside to veneers is they are what people use when they are looking for a complete smile makeover. It can change everything about your smile including the shape, size, and color. The downside is they are more expensive than teeth whitening. If you’re okay with getting it close and don’t want to change anything else about your smile then you can save money with teeth whitening. It all depends on what your goals are.

I hope this helps you.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Does She Need a Root Canal Because of Crest Whitestrips?

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Years ago, I had a tooth with trauma that knocked it back a bit. I had it fixed by an oral surgeon. Eventually, it turned dark. The gum is also a bit recessed. I asked my dentist about whitening my teeth. He doesn’t do the teeth whitening procedure but did recommend I get some Crest Whitestrips and said that they do whiten teeth slowly. I got a box and used it for seven days. That’s when the formally injured tooth started aching. I stopped using the whitestrips and still another week later it was still hurting. I went to see him and he ran some tests and it appears this tooth now needs a root canal treatment. Was this because I used the whitestrips?

Sandy

Dear Sandy,

teeth bleaching trays

Teeth Bleaching Trays

Usually Crest Whitestrips are too weak to do any damage, which is why they are available over the counter instead of through a medical professional. However, this tooth had some additional problems and the whitening gel may have thrown it over the edge.

Your dentist had a misunderstanding of how teeth whitening works. When you whiten your teeth, it whitens the teeth evenly. This tooth, which needed the root canal treatment would not have been affected. This would only make it look worse compared to your other teeth.

As you are going to get a root canal treatment, you will need a dental crown. Please don’t have this crown done by your current dentist. Teeth whitening is one of the easiest cosmetic procedures there is and he did not understand that at all. Getting a dental crown to cover a dark tooth will take a much more advanced cosmetic dentist.

Look for someone with a smile gallery and post-doctoral training in cosmetic work. Then look at the procedures on their smile gallery that are similar to your needs. When they do the crown, they should try it in with a temporary try-in past. You should be able to look at the crown in several types of lighting to make sure it matches well and you love the way it looks. If you don’t, they need to be wiling to redo it.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

How Can I Get REALLY White Teeth?

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I went to my dentist asking about teeth whitening. He does not do the procedure himself but told me that Crest Whitestrips work. I’ve been using them for a while now. While I can tell they are making a small difference. It is very small. I’m looking for a way to get my teeth very white. Is there another product that will do that?

Sandy

Dear Sandy,

teeth bleaching trays

Teeth Bleaching Trays

I am glad you wrote. While your dentist is correct that the over-the-counter product, Crest Whitestrips, will whiten your teeth, as you have experienced it does so very slowly. This is because any product you can purchase over-the-counter cannot be very strong for safety reasons.

There are two ways to get really strong teeth. The first is professional teeth whitening. When you have your teeth whitening done, you are under the care of a medical professional who keeps an eye on things. That allows you to get a much stronger gel, which you give you faster results.

A second option is to get porcelain veneers. These are generally used for a complete smile makeover. It’s what all those film stars use in Hollywood. The big benefit to these is that they can change more than your color. They can also remake the size and shape of your teeth, which can completely remake the character of your smile. This is a much more expensive procedure than teeth whitening. You should also be aware that though just about any dentist can do the teeth whitening procedure with no problems, it takes post-doctoral training for a dentist to be able to do porcelain veneers.

The good news is that nothing will get your teeth whiter than persistence using teeth whitening trays. It’s okay that your dentist does not do the procedure. For this, you can go to another dentist to have the whitening done and then return to your dentist for your general dental work.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

 

Porcelain Crowns Turning Yellow

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I had six porcelain crowns done for a smile makeover. They looked beautiful when I first got them. It’s been a little over six months and now they are starting to pick up stains. I don’t drink or smoke but do drink one cup of coffee every morning. I do brush twice a day and floss. Do you know what is going on? Is this normal? I really liked them when I first got them. Will teeth whitening get them back the way they were?

Maxwell

Dear Maxwell,

woman covering her mouth

No, this is not normal. Porcelain is very stain resistant. In fact, your porcelain crowns should be more stain resistant than your natural teeth. Something has happened to these. Nothing you described would be consistent with causing damage to your porcelain veneers. Either your dentist did not give you actual porcelain crowns or something did damage them.

You mentioned that it has been a little over six months since you had your porcelain crowns placed. This would be right about the time you might go in for a dental checkup and cleaning. It is possible that the hygienist used something known as a Power Prophy Jet or acidulated fluoride during your cleaning. The acidulated fluoride will cause damage to the glazing of the porcelain veneers, which is what protects the crowns from picking up stains. The Prophy Jet will remove the glazing altogether.

Either not using porcelain or one of the two dental procedures I mentioned could have caused the damage you are describing. Finding out what happened is going to require you getting a second opinion. I suggest that you get a second opinion from an expert cosmetic dentist. When you do, however, I want you to be sure not to tell him who your dentist is. Just go and explain that you have only had these porcelain crowns for just over six months and see if he or she can tell you why they are picking up stains. If the dentist asks who did the work before giving his or her diagnosis tell them that you are looking for an unbiased opinion and don’t want to give the name of the practitioner. They should understand that.

Unfortunately, teeth whitening will not give them back their color. Bleaching only works on natural tooth structure. The crowns will need to be replaced. That is why it is important that you figure out why this happened. If the dentist is at fault, he or she should replace them for you free of charge.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Should I Buy Dental Veneers Online?

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I want to fix my discolored and uneven teeth. My dentist is suggesting doing  bonding on the ten top teeth for $2000. My concern is that I had a chipped tooth that I had my dentist fix with composite bonding a few years ago. It looked pretty bad and the new part of the tooth with the composite did not match the rest of the tooth. I’m still stuck with this and am worried that the rest of my teeth will be problematic if he does it. I spoke with him about porcelain veneers instead and that is pretty pricey. I can get them online a lot cheaper. Would that be the better option for me?

Breanna

Dear Breanna,

Before and After Dental Bonding repairing a chipped tooth

First, do not do the composite bonding, even though it is cheaper. I’ll get to the online veneers in a moment. When composite dental bonding is done correctly, then the results can look perfectly natural, as seen above. However, it has to be done by a dentist with the right training and skills. Both porcelain veneers and dental bonding are advanced dental procedures that require post-doctoral training. It does not sound like your dentist has this training.

Usually dental bonding when done over the full surface of the tooth, as your procedure would need would cost a LOT more than your dentist is asking because it has to be done freehand and would need more chair time. This gives me additional concerns about his skill level or understanding of the procedure. You didn’t mention the porcelain veneers price, but I would expect them to be quite expensive as well.

If you get online veneers, the one thing you will have going for you is that they are removable if you hate them. These do not get permanently bonded on your teeth the way porcelain veneers done by a skilled cosmetic dentist will be. These are not really made out of porcelain either. These online veneers are usually made of acrylic and do not look like natural teeth. They’re better suited to a photo shoot or a one night event.  If you want a beautiful smile, this is not the way to go. If you want something okay that you can pop in and out, this will do just fine.

If a gorgeous smile is what you ultimately desire, I suggest starting with teeth whitening. Bear in mind, the chip you had repaired will not whiten with the remainder of your teeth. It sounds like that needed to be redone anyway, which leads me to the second thing I want to suggest. Find a truly skilled cosmetic dentist. They can repair your bonding. Then, find out how much they charge for porcelain veneers. It will be expensive, but the teeth whitening will dramatically improve your smile and give you time to save up for any further work you may want done.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

 

Teeth Whitening or Fillings First?

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I have a canine tooth that needs to have a dental crown on it. My teeth are kind of yellow so my dentist told me if I wanted to get them whitened I should do it before I have the dental crown made because the color for that cannot be changed once it is done. Something I am wondering about, though, is all the fillings I have. They are silver and probably need to be replaced anyway. Some of them are visible when I smile. Should I replace the fillings first with those white ones and then bleach my teeth to match them or should I whiten the teeth and then get the fillings done?

Bridgette

Dear Bridgette,

Teeth Whitening trays

 

I would start with the teeth whitening. It is nearly impossible to get teeth whitening to an exact match to a color. But, you can whiten your teeth to a color you love and then the composite fillings as well as the canine dental crown can be made to match.

I want to give you a couple of precautions. The teeth whitening itself is easy and just about any dentist can do it. The canine you want to be more careful with. First, make sure that your dentist uses a porcelain crown. These are much more natural looking. A metal-based crown will be too opaque and, eventually, will give you quite an unsightly gray line at the gumline. In order to ensure your dentist is able to properly match your dental crown, make certain that he or she uses a temporary try-in paste and then allows you to look at it in several different types of lighting. If you don’t like the crown, your dentist should send it right back to the lab in order to make any changes that you need.

Replacing Amalgam Fillings

One other very important piece of information. Silver fillings are made mostly of mercury. You want to be certain that whoever switches out your fillings knows how to do a sanitary amalgam removal. This will prevent you from inhaling any mercury vapors or swallowing any pieces of mercury. As you know mercury is a toxin and people have serious health repercussions from mercury poisoning.  This is actually why so many patients are anxious about their silver fillings and want to replace them, though the American Dental Association still considers them safe.

I recommend seeing a mercury-free dentist in order to have them removed and then ask him if they know how to do a sanitary amalgam removal.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Fixing Enamel Hypoplasia

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I have had enamel hypoplasia for as long as I can remember. I’ve always been embarrassed by my smile as a result. For my Christmas present, my husband said I could have any cosmetic dentistry procedure I need that will make me more comfortable smiling. I am so freaking excited!! The only problem I have is that I do not know what procedure I need to get. Do you have a recommendation?

Madilyn

Dear Madilyn,

Examples of mild and severe enamel hypoplasia

What an exciting present for you! There is no better feeling than a smile that makes you feel confident. For the benefit of those who may not be aware of what enamel hypoplasia is let me give a basic rundown. Enamel hypoplasia is a either caused by a genetic defect or disease that happens during the development of your teeth. The result is that the enamel on  your teeth do not fully develop. The results can vary between  some decalcification, such as on the left or deep pitted teeth, such as on the right.

There are two good treatments for enamel hypoplasia. Which you get depends on the severity of your particular case. If you are dealing with mild hypoplasia, then dental bonding is a perfectly good solution. If you want your teeth whiter, make sure you have teeth whitening done before the bonding. Once the dental bonding is completed, the color can’t be changed.

If, however, you have more severe hypoplasia, then you will want to get porcelain veneers instead. While dental bonding can just be placed on the specific spots where your enamel is affected, porcelain veneers will cover the entire front surface of your teeth.

Regardless of the procedure chosen, you will need someone with post-doctoral training in cosmetic dentistry. These are both advanced procedures. You would be wise to take a look at their smile gallery. This will have before and after images of their work. You want to feel excited about the type of results they get.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Covering Tetracycline Stains if You Can’t Afford Porcelain Veneers

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I have had very discolored teeth since my childhood. They said it was because of some medication I took as a child. When I was in high school my parents spent practically everything they had to get me dental bonding. Now that I am older the bonding is completely worn out. I know the better solution is porcelain veneers, but I cannot afford that. Dental bonding is not much less. Is there any chance there are newer procedures that have improved which could help me get a prettier smile without porcelain veneers?

Mandy

Dear Mandy,

teeth bleaching trays

Teeth Bleaching Trays

 

The medication you took as a child was likely tetracycline. If taken while your teeth are still forming, then it can cause brown stains on your teeth. If you cannot afford porcelain veneers to this and you have existing bonding you have options, but it depends on how the dental bonding was done.

If the dental bonding was placed over intact enamel, then there are sandpaper disks that can be used to remove the outdated bonding. It’s not too hard to do if they have training. In fact, some states will allow a dental hygienist to do it. If your state allows that, the fee should be a bit lower, which could save you more money.

Once the old bonding is removed, have your dentist make for you some custom-fitted teeth whitening trays like the ones pictured above. Then you will simply use some professional strength teeth whitening gel in the trays. You will have to be persistent and it will take a while, but you can get your teeth significantly whiter. They won’t be as beautiful as they would with well done porcelain veneers, but you will no longer be embarrassed by your teeth.

Be aware you will want to stick with the tray and gel approach. Don’t let your dentist talk you into something like Zoom Whitening or Laser teeth whitening. While these are stronger, you would require so many treatments that it would quickly get too expensive. Just persevere with the gel and you will get results.

If, however, the dentist removed some of your tooth enamel before placing the dental bonding, then there is no other solution except for porcelain veneers. In that case, I would just wait and save up to have the porcelain veneers done. Don’t try to save money by using just a basic family dentist. Save up to do it right. Make sure the dentist has post-doctoral porcelain veneers training. I’d also check their smile gallery to make sure they can produce artistic results. Tetracycline cases are one of the most advanced cosmetic cases a dentist can do so you want to make sure they have the skills to do it well.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

My New Dental Crowns are Turning Yellow

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I had very white teeth and was ready to take the next step in improving my smile by getting a smile makeover. I spoke to my dentists and he suggested six porcelain crowns on my upper front teeth. I selected the whitest color available to me. Yet, when the crowns were put in, they did not seem to be the whiteness I had intended for them. Now, to top it all off, the dental crowns are starting to turn yellow. I haven’t even had these a year yet. Can I whiten them along with my teeth? How do I keep them from turning yellow again?

Melody

Dear Melody,

Extended shade guide

First, I want to make sure your dentist is using the updated shade guide. Before teeth whitening, the whitest shade was B1. Now, with the popularity of teeth whitening, the shade guides have been updated and BL1 is now the whitest. That may be the issue with the color discrepancy.

That doesn’t, however, explain the new staining. If your crowns are truly porcelain crowns they should be very stain resistant as long as the glaze on the porcelain is intact. This leaves me to wonder if something happened during one of your dental appointments to damage the crowns. Two possibilities are if the hygienist used an acidulated fluoride or a power prophy jet.

With the acidulated fluoride, it will etch the surface of the crowns, leaving the crowns very susceptible to staining. The power prophy jet can remove the glazing, causing staining take place even faster. Unfortanately, teeth whitening only works on natural teeth, so that would not be a good solution for you. The first step is to find out if the glazing has been damaged. I recommend seeing a good cosmetic dentist who can examine your crowns and ask them to give you an idea of why these are picking up stains.

One other quick question. I’m curious as to why your dentist chose crowns for this smile makeover. The standard for that type of procedure is porcelain veneers because it removes much less tooth structure. Was there damage to these teeth that required crowns?

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.